Impact of surgically induced weight loss on pelvic floor disorders
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Introduction and hypothesis
Given the increased prevalence of obesity and pelvic floor disorders (PFDs), we estimated changes in prevalence, bother, and quality of life (QOL) for PFDs in obese women undergoing bariatric surgery. We hypothesized PFDs would improve after surgical weight loss.
The prevalence, bother, and QOL impact of PFDs were estimated using validated measures. McNemar’s and paired t tests were used to compare pre- and postprocedural outcomes. Power calculations deemed that 90 individuals would achieve at least 80 % power to detect a decrease in prevalence of 12 %.
The baseline mean (± standard deviation) age and body mass index (BMI) of the 98 women were 43.3 ± 11.8 years and 39.7 ± 6.2 kg/m.2 BMI decreased to 34.4 ± 5.8 at 6 months and 34.0 ± 5.6 at 12 months. Whereas the overall prevalence of stress urinary incontinence (SUI) decreased from 22/69 (32 %) at baseline to 10/69 (15 %) at 6 months (p = 0.006) and 14/69 (20 %) at 12 months (p = 0.027), there were no significant decreases in overall prevalence of other PFDs. However, for women with SUI, overactive bladder (OAB), and anal incontinence at baseline, 11/23 (48 %), 8/11 (73 %) and 4/20 (20 %) resolved at 12 months, respectively. Pelvic Floor Impact Questionnaire scores decreased from baseline to 12 months (p < 0.001). Mean visual analog scores for women with SUI, OAB, and anal incontinence decreased at 12 months.
Surgical weight loss resulted in resolution of symptoms in nearly half of women with SUI and three quarters of women with OAB and was associated with significant improvement in QOL.
KeywordsPelvic floor disorders Surgical weight loss
American Urogynecologic Society Foundation Research Grant
Financial disclaimer/Conflict of interest
EL Whitcomb: AUGS Foundation Grant; MC Donohue: Bristol-Myers Squibb; S Horgan: Ethicon; ES Lukacz: Ethicon, Pfizer, Renew Medical
- 1.Organization WH. Obesity and overweight. Available at: http://wwwwhoint/dietphysicalactivity/publications/facts/obesity/en/ Accessed November 8, 2010
- 4.Control CfD. Obesity epidemic increases dramatically in the United States: CDC director calls for national prevention effort. Available at: http://wwwcdcgov/od/oc/media/pressrel/r991026htm Accessed November 8, 2010
- 5.Sung VW, Washington B, Raker CA. Costs of ambulatory care related to female pelvic floor disorders in the United States. Am J Obstet Gynecol May;202(5):483 e1-4Google Scholar
- 12.Cuicchi D, Lombardi R, Cariani S, Leuratti L, Lecce F, Cola B. Clinical and instrumental evaluation of pelvic floor disorders before and after bariatric surgery in obese women. Surg Obes Relat Dis Aug 28Google Scholar
- 21.Zeger SLaL, K.Y. (1986) Longitudinal data analysis for discrete and continuous outcomes. Biometrics 42:121-30Google Scholar